Fanconi Syndrome

A 10-year-old girl with a past medical history of epilepsy presents to the emergency room after sustaining a fall on the playground. She was fatigued and confused after the event and complained of pain in her wrist. On review of systems, she endorsed polyuria and polydipsia. Relevant medications included valproic acid, started 6 months ago, for her epilepsy. On physical exam, her right wrist was erythematous, swollen, and tender. Laboratory evaluation revealed hypokalemia, hypocalcemia, hypophosphatemia, and a mild metabolic acidosis.